What is Paretic Propulsion, and Why Does it Matter?

Watch this highlighted clip to hear from Kathleen O’Donnell as she takes us through an exercise to help us understand the relationships between ankle plantarflexion, trailing limb angle, and forward propulsion in the gait cycle, and highlights why it is so important to retrain for effective propulsion symmetry in patients post-stroke.

These principles are the foundation of the ReStore Exo-Suit, which helps to train effective plantarflexion function and timing for patients undergoing clinic-based gait rehabilitation after a stroke.

You can learn more about the ReStore Exo-Suit on the ReStore product page.

This is a highlighted clip from ReWalk’s Topics in NeuroRehabilitation web series. You can watch the full episode here.





So we also looked into, OK,

if we know that propulsion is important

and we know it’s something that we’re

we’re sort of challenged to address

in the clinic,

how can we think about propulsion?

How can that really be generated?

And we saw from Mike Lewek in Episode 08,

he did a really nice job of breaking down

the two subcomponents of propulsion.

So he specifically talked about the ankle

plantarflexion, or the forces generated

at the ankle to really push down

into the ground and push the ankle

down and drive the body forward.

And then he also talked about the

importance of the trailing limb angle.

So this is the angle that your leg is

basically behind your

body’s center of mass.

So, how far behind you is that leg when

you’re doing that ankle plantarflexion?

So we put together a quick video just

to sort of help everybody understand

this a little bit deeper.

So what I’m going to have all of our

viewers do is if you can stand up where

you are, and what I want you to do

is just put your hands on your hips.

And the first thing we’re going to do

is explore that ankle plantarflexion.

So if you raise up onto your toes and so

you’re plantarflexing your ankles,

what I want you to do is feel

the direction that your hips are moving.

And you’re going to notice that your hips

are just moving straight up

because plantarflexion when your foot is

underneath you is going to move the weight

of the body up, but not move

the weight of the body forward.

So now we’re going to try this again,

and I’m going to have you take a step

forward with your left foot,

and now I want you to raise up

on the toes of your right foot.

And now you’re going to feel that when you

have your hands on your hips,

your hips are actually translating

forward as you raise up on your toes.

So you can see that it’s not just

the ankle plantarflexors that matter,

but it’s also the angle that they are

and the angle that your leg

is with respect to your body.

And we also heard from Lou Awad in that

same talk about why this really matters.

Why we care about propulsion asymmetry is

that it really translates and correlates

with all of these other metrics that we

look at to really see how that affects

that patient’s community

ambulation and quality of life.

And that’s really what the goal of gait

training is, is to get somebody back

to their highest level of function

in their highest quality

of life that they can achieve.

This has been a highlighted clip

from ReWalk’s Topics

in NeuroRehabilitation web series.

To watch the full episode,

please go to the ReWalk Robotics YouTube

page, or visit the link

in the comments below.

See you next time!


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